Article

Treatment Outcome and Relapse with Short-term Oral Terbinafine (250 mg/day) in Tinea Pedis

Department of Dermatology, Showa University Fujigaoka Hospital, Kanagawa, Japan.
Nippon Ishinkin Gakkai Zasshi 02/2005; 46(4):285-9. DOI: 10.3314/jjmm.46.285
Source: PubMed

ABSTRACT

A total of 168 patients with tinea pedis, but without onychomycosis, were treated with 1 cycle of terbinafine (TBF) (1 cycle: defined as 250 mg/day for 1 week). KOH preparation for direct microscopy was performed 4, 8 and 12 weeks after starting therapy to determine if testing was positive for tinea. Patients with no negative results on KOH examination or no evidence of obvious clinical improvement at 8 weeks, another cycle of the therapy was prescribed. The "cure", "no cure", "dropout", and "discontinuation/unevaluable" rates were 89.3%, 4.8%, 4.8% and 1.2%, respectively. The number of cycles required for cure in the plantar type was 1 cycle in 65.9% and 2 cycles in 54.5% of cases; in the interdigital type, 1 cycle in 79.1% and 2 cycles in 20.9% of cases; and mixed type, 1 cycle in 29.1% and 2 cycles in 60.9% cases. Among patients who were followed for at least 3 years after cure, the relapse rates were about 10% each year: 1 year, 11.3%; 2 years, 8.9%; and 3 years, 11.2%. The relapse rate of about 10% each year over a 3-year period suggests that reinfection may be likely.

  • Source
    • "Once an infection is established, the wearing of sports shoes and other types of occlusive footwear provides an ideal microclimate in which these fungi can thrive, and may lead to nail infections (tinea unguium), which are inherently harder to treat. It has been estimated that there is a relapse rate of 10 % a year in cases of tinea pedis treated with oral terbinafine (Takiuchi et al., 2005), while 22 % of patients with tinea unguium treated with systemic antifungals relapse within 3 years (Tosti et al., 1998). The design of effective intervention measures to break the cycle of transmission is a central requirement for reducing the incidence of dermatophytoses. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The sequence of the nontranscribed spacer (NTS) region of the rDNA of Trichophyton mentagrophytes var. interdigitale strain 2111 was determined, and three individual subrepeat loci identified. The first repeat region contained eight tandem copies of a degenerate 33-43 bp sequence, whilst the second had two complete and two partial 300 bp repeats. The third locus contained six tandemly repetitive elements of between 67 and 89 bp, which showed sequence identity to the TrS2 repeats of Trichophyton rubrum. PCR amplification of the individual repetitive regions from 42 random isolates of T. mentagrophytes var. interdigitale identified fragment length polymorphisms at each locus. Sequence analysis of the PCR products revealed that the size variations resulted from differences in the copy number of each of the three sets of subrepeat elements, TmiS0, TmiS1 and TmiS2. In addition, some indels were present in the flanking regions of the TmiS1 repeats. Combining PCR fingerprints from each of the three polymorphic loci produced a total of 19 individual strain profiles. The method was rapid, reproducible and discriminatory, and the fragment patterns simple to interpret. PCR fingerprint analysis of variable tandem repeat loci in the T. mentagrophytes var. interdigitale NTS represents a valuable molecular typing method for future epidemiological investigations in this species.
    Full-text · Article · Nov 2006 · Journal of Medical Microbiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of mycotic infections is on the rise in the United States. The failure of patients and clinicians to recognize a fungal infection early may lead to extensive, severe, and difficult-to-treat disease. Treatment decisions must include an awareness of the etiologic organism involved, the potential for long-term recurrence, symptoms such as inflammation and itching, and the importance of patient adherence to treatment. Sertaconazole nitrate, a broad-spectrum imidazole agent with antifungal, antibacterial, antiinflammatory, and antipruritic properties, is the topical antifungal agent most recently approved by the US Food and Drug Administration. A review of its mechanisms of action, pharmacokinetic profile, fungistatic and fungicidal activities, and clinical properties examines a substantial body of research findings that establish its efficacy, safety, and tolerability. Its use in the treatment of tinea pedis and other superficial mycotic infections is reviewed here.
    No preview · Article · Jul 2008 · Cutis; cutaneous medicine for the practitioner

  • No preview · Article · Sep 2008
Show more